Her Crusade--Put Minorities in Medicine

Althea Alexander was embarrassed to admit it, but when a Latino nurse came into her office last year to say thank you, she drew a blank.

More than 20 years had passed since they met, and in that time Alexander, the assistant dean of minority student affairs at the USC School of Medicine, had looked into the faces of thousands of youngsters who needed help believing they could become doctors and nurses.

But then Martha Saldana Arellano opened her wallet and took out a tattered piece of paper. “When you get to the top of the hill,” said the inscription, penned by Alexander when Arellano was just 14, “keep climbing.”

“She kept it in her wallet for 22 years. All I could do was cry,” said Alexander, still visibly moved by Arellano’s gratitude--and by the underlying reason for her visit: “Now,” Alexander said with a sparkle in her eye, “her daughter is interested in medicine.”

Better than most, Alexander, 54, knows how uncommon it is to meet a second generation doctor or nurse whose skin is black or brown. Since 1968, when she came to USC and found one black and one Latino enrolled in the medical school, she has worked to increase the ranks of minorities by convincing young people that a medical career is within their reach.

It is not easy. Despite the pressing need for health care professionals in minority communities, many black, Latino and American Indian students are still discouraged by inadequate academic preparation, limited financial resources and the lack of role models. The result can be seen in the complexions of the nation’s medical students: In the 1990-91 academic year, only 5.9% of students who graduated from medical school were black, compared to 11.7% of the U.S. population. Latinos, who made up 9.1% of the population, accounted for only 5.1% of medical school graduates.

But according to her colleagues and students at USC, Alexander has found a way to beat the odds and inspire the self-confidence that is essential to survive medical school. Today, roughly one in six medical students at USC are minorities--about 16%.

Over the past two decades, Alexander, who is black, has earned a reputation across the country as an impassioned pioneer in the fight to include minorities in medicine’s academic mix.

“It isn’t just a parochial effort on her part, but a national concern for all minority students. She is clearly a leader nationwide,” said Dario Prieto, a past director of the American Assn. of Medical Colleges’ Office of Minority Affairs, who for 15 years worked closely with Alexander and her counterparts at the nation’s other 126 medical schools.

The key, Alexander says, is to start early.

“This society has never told (minority students) ‘you have the intelligence, the capability, the sensitivity to be a doctor,’ ” Alexander said. “We have to train young people to make a contribution to society. If someone would give us a grant to start in kindergarten, I would do that.”

Instead, she roams the halls at junior and senior high schools, seeking out promising youngsters and, as one USC alumna describes it, “grabbing hold.”

Alexander grabbed hold of Osbourne Blake after she spoke to his ninth-grade class 10 years ago in Brooklyn, N.Y.

Blake introduced himself and, his phrases broken by a serious stutter, asked Alexander if she would advise him by mail. He remembers writing her about his dream of being a doctor. And he remembers her response: “One day, you’ll be one.”

Years later, while Blake was attending Brown University, Alexander helped him enroll in USC’s summer enrichment classes for minority premed students and encouraged him to speak with assurance.

“She would put me on the spot, get me used to talking in front of groups,” he said. Blake, now 22, is in his first year at USC Medical School. Partly because of Alexander, he said, his stutter has disappeared.

Stories of Alexander’s perseverance abound. She calls. She writes. She meets with the families of bright students and makes them a promise: If their child excels in school, volunteers at a hospital and spends summers in the university’s premed program, she will do her best to find them a place in medical school.

Through tireless lobbying and sometimes pointed criticism, she has pushed admissions committees to look favorably on the non-traditional experiences of minorities. Along with grade-point averages and test scores, Alexander said, schools should consider an applicant’s work and family history. Did she hold down a job while in school? Is he a single parent? How committed are they to serving their communities?

Once a minority student is admitted, Alexander does not stop there. Students say she has a sophisticated understanding of how the color of their skins can put them under additional stress. Mario Helmsley, a black pediatrician who trained at USC, recalled that as a student he sometimes felt he was representing his entire race.

“Whenever I raised my hand to answer a question, it was like an E. F. Hutton commercial,” he said, recalling the hush that would fall over the room when he spoke. “It was intimidating.”

Once, Alexander introduced one of her USC colleagues to a medical school applicant who stood 6-foot-3, weighed 200 pounds and is black. The colleague shook the student’s hand and asked warmly, “So? Do you play football?”

Later, Alexander returned to the colleague’s office to suggest that, in the future, he focus on the brains--not the brawn--of minority students, who too often are valued only for their athletic ability.

Alexander’s willingness to confront even the most subtle prejudice has, on occasion, earned her a reputation for being difficult.

“This is not a utopia,” Alexander tells students. “You are what you are. . . . You cannot die on every hill here. If somebody makes a racist comment in class, you cannot spend all your energy on that. Be principled and deal with it. Say: ‘I don’t appreciate that.’ Then, move on.”

Ask Alexander about herself, and you will hear a long list of other people’s names--doctors who have volunteered to teach in the summer program, USC administrators, other minority recruiters--who she says are much more deserving of attention.

“I am not the story,” she insisted. “I am just a catalyst. You can’t do this job with just one person.”

But those who know Alexander say that while USC pays her salary, her impact is felt at schools nationwide.

“She has mentored people all over this country,” said Oscar Streeter Jr., an assistant professor of radiation oncology at USC who met Alexander when he was a USC undergraduate and then attended Howard University School of Medicine. “She is the one everybody comes back to and says, ‘Thank you.’ They may have gone to another medical school, but they know a significant reason they are physicians is because of Althea.”

The only child of a union organizer in Berkeley, Alexander grew up equating independence with strength. Her father believed so strongly in learning by doing, she said, that he taught her to drive by handing her the car keys. Swimming lessons, she says with a grimace, were the same: He threw her in.

“He would say: ‘You have to have the courage of your convictions.’ I’d say: ‘But dad, I’m scared.’ And he’d say: ‘Well, do you want to drive?’ ” she says with a laugh. “It’s lucky I didn’t kill myself.”

Around the kitchen table, she learned to hold her own, respectfully, in philosophical arguments about everything from politics to religion (her mother was a devout Catholic; her father an atheist).

As a child, her father took her to the fields to talk to farm workers about their rights. As a young adult, while obtaining her degree in psychology from USC, she was active in the Unitarian Church and in Quaker youth programs that she says reinforced her belief that experience builds self-reliance.

While attending a Quaker conference in 1960, Alexander met her husband, Fred--who is the chief of internal medicine at Kaiser Permanente West Los Angeles.

They remember the moment well. Althea was walking on the beach with the conference’s keynote speaker, an eloquent black preacher from Atlanta, when Fred approached from the opposite direction and called her by name. They had met as children--Fred’s father was a union organizer, too--and he remembered her face.

Moved to have witnessed this reunion, the preacher, Martin Luther King Jr., invited Fred to join him and Althea on their walk. A year later, the Alexanders were married, and by 1964, they had a son, Sean, and a daughter, Kim.

With a story like that in the family, perhaps it is inevitable that, when Alexander speaks to young people, King gets frequent mention. So do Sojourner Truth, Harriet Tubman, Frederick Douglass and Thurgood Marshall. Photos of Cesar Chavez, Emilio Zapata, Sidney Poitier and Harry Belafonte adorn the walls of her three-room basement office, the meeting place for USC’s minority doctors-in-training.

Officially the suite, located down the hall from an anatomy lab, houses the office of minority affairs. But Alexander said she encourages students to think of the place and its worn-out sofas as theirs--a safe haven, a place to get recharged.

She remembers one minority student who, for the first time, had lost a patient. Immediately after the death, he forced himself to remain composed in front of the other doctors, most of them white. He then headed for the safety of Alexander’s office, where he sobbed for more than an hour.

“He already had the monkey on his back--he was a minority,” Alexander said. “He did not want to be the one to break down.”

Minority students seem always to fall back on comforting images when they speak of Alexander and her office--a home away from home, says one; a surrogate mother, says another. Indeed, Alexander’s relationship with students seems almost familial.

When they are sick, she delivers chicken and waffles to their hospital beds. When they are alone on holidays, she invites them for dinner at her Hollywood home. She has been in at least one student’s wedding party and has found jobs for more people than she can remember.

Each student has a favorite story about Alexander. One black student, a single father, told how she fought to win back his food stamps after welfare officials, confused by his hefty scholarship, took them away. A Latino student recalled that when his first round of exams prompted a crisis of confidence, Alexander contacted a Latino alumnus, now a doctor at UC San Francisco, to fly down for the weekend and reassure him.

Dr. Rebecca Wills, the first black woman ever to graduate from the USC School of Medicine, recalls that when, as a third-year student, she was hospitalized after a serious car accident, she found herself crying out not for her own parents, but for Alexander.

“A lot of succeeding in medical school is having a psychological support system,” Wills said, adding that especially for minority students “you need a constant reminder: ‘Yes, you can.’ Althea fills that void.”

She also builds alliances within the faculty. And, with another colleague, she reviews every minority candidate’s application to USC, often reading 150 a week. As one of three minority members on a panel of 18, she takes her role on the admission’s committee very seriously.

Once, while hurrying to a committee meeting, she tripped and broke her arm. She went to the meeting anyway. Later, when she finally went to get her fractured arm set--at a colleague’s insistence--Alexander was reminded of the prevailing stereotypes that her students encounter every day.

At the County-USC emergency room, she was examined by a white resident who, unaware of who she was, told her to “hold your hand like you hold your can of beer on Saturday night.” She was so shocked that she made him repeat himself. Then she took him to task.

“You saw I was black and assumed I was on welfare, didn’t you?” she asked. Embarrassed and a little frightened, he said yes. “And you assumed I had five illegitimate children at home too?”

Later, the resident visited her office several times to apologize. Once, he brought flowers.

“I told him to keep his flowers and give them to a girlfriend,” Alexander said. “What I wanted was for him to change his ideas.”